Skip to main content
Erschienen in: Clinical Rheumatology 9/2007

01.09.2007 | Original Article

Surgical outcomes and risk factors for postoperative complications in patients with Behcet’s disease

verfasst von: Min-Chan Park, Bum-Kee Hong, Hyuck Moon Kwon, You-Sun Hong

Erschienen in: Clinical Rheumatology | Ausgabe 9/2007

Einloggen, um Zugang zu erhalten

Abstract

This study aims to investigate surgical outcomes in patients with Behcet’s disease (BD) and to identify risk factors for the occurrence of postoperative complications. The medical records of 37 patients with newly diagnosed BD were reviewed retrospectively. All patients fulfilled the International Study Group criteria for diagnosis of BD and underwent surgeries after diagnosis. Demographic, clinical, and laboratory data at the time when surgeries were performed were collected and surgical modalities, postoperative complications, and postoperative medical treatments were evaluated. Forty-three surgeries were performed in 37 patients. During mean follow-up duration of 78.2 ± 50.3 months, 14 surgeries (32.6%) were complicated by wound dehiscence, infection, and graft occlusion or failure with the mean lag time of 6.0 ± 4.6 months from surgeries. Cumulative incidence of postoperative complications was 7.7% at 3 months, 25.6% at 6 months, 33.3% at 12 months, and 35.9% at 18 months. Postoperative complications occurred more frequently after surgeries that were performed in patients with positive pathergy test (P < 0.001) and after vascular surgeries than after nonvascular surgeries (P < 0.05). Moreover, surgeries that were followed by glucocorticoids with immunosuppressive agents showed a significantly lower postoperative complication rate compared to those that were followed by glucocorticoids alone and those that were not followed by medical treatment (P < 0.05). Multivariate analysis showed that a positive pathergic reaction (P < 0.05, hazard ratio = 1.91) at the time of surgery and surgeries that were not followed by treatment with glucocorticoids and immunosuppressive agent (P < 0.01, hazard ratio = 2.11) was an independent risk factor for the occurrence of postoperative complications. Our findings suggest that the occurrence of postoperative complications can be reduced when postsurgical immunosuppressive treatment was implemented and that the pathergy test can be used as screening methods for occurrence of postoperative complications in patients with BD.
Literatur
1.
Zurück zum Zitat Sakane T, Takeno M, Suzuki N, Inaba G (1999) Current concepts: Behcet’s disease. N Engl J Med 341:1284–1291PubMedCrossRef Sakane T, Takeno M, Suzuki N, Inaba G (1999) Current concepts: Behcet’s disease. N Engl J Med 341:1284–1291PubMedCrossRef
3.
Zurück zum Zitat Kural-Seyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V et al (2003) The long-term mortality and morbidity of Behcet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine 82:60–76PubMedCrossRef Kural-Seyahi E, Fresko I, Seyahi N, Ozyazgan Y, Mat C, Hamuryudan V et al (2003) The long-term mortality and morbidity of Behcet syndrome: a 2-decade outcome survey of 387 patients followed at a dedicated center. Medicine 82:60–76PubMedCrossRef
4.
Zurück zum Zitat O’Duffy JD (1990) Vasculitis in Behcet’s disease. Rheum Dis Clin North Am 16:423–431PubMed O’Duffy JD (1990) Vasculitis in Behcet’s disease. Rheum Dis Clin North Am 16:423–431PubMed
5.
Zurück zum Zitat Duzgun N, Ates A, Aydintug OT, Demir O, Olmez U (2006) Characteristics of vascular involvement in Behcet’s disease. Scand J Rheumatol 35:65–68PubMedCrossRef Duzgun N, Ates A, Aydintug OT, Demir O, Olmez U (2006) Characteristics of vascular involvement in Behcet’s disease. Scand J Rheumatol 35:65–68PubMedCrossRef
6.
Zurück zum Zitat Atzeni F, Sarzi-Puttini P, Doria A, Boiardi L, Pipitone N, Salvarani C (2005) Behcet’s disease and cardiovascular involvement. Lupus 14:723–726PubMedCrossRef Atzeni F, Sarzi-Puttini P, Doria A, Boiardi L, Pipitone N, Salvarani C (2005) Behcet’s disease and cardiovascular involvement. Lupus 14:723–726PubMedCrossRef
7.
Zurück zum Zitat Yurdakul S, Tuzuner N, Yurdakul I, Hamuryudan V, Yazici H (1996) Gastrointestinal involvement in Behcet’s syndrome: a controlled study. Ann Rheum Dis 55:208–210PubMed Yurdakul S, Tuzuner N, Yurdakul I, Hamuryudan V, Yazici H (1996) Gastrointestinal involvement in Behcet’s syndrome: a controlled study. Ann Rheum Dis 55:208–210PubMed
8.
Zurück zum Zitat Jorizzo JL, Solomon AR, Cavallo T (1985) Behcet’s syndrome. Immunopathologic and histopathologic assessment of pathergy lesions is useful in diagnosis and follow-up. Arch Pathol Lab Med 109:747–751PubMed Jorizzo JL, Solomon AR, Cavallo T (1985) Behcet’s syndrome. Immunopathologic and histopathologic assessment of pathergy lesions is useful in diagnosis and follow-up. Arch Pathol Lab Med 109:747–751PubMed
9.
Zurück zum Zitat Ehrlich GE (1997) Vasculitis in Behcet’s disease. Int Rev Immunol 14:81–88PubMed Ehrlich GE (1997) Vasculitis in Behcet’s disease. Int Rev Immunol 14:81–88PubMed
11.
Zurück zum Zitat Bradbury AW, Milne AA, Murie JA (1994) Surgical aspects of Behcet’s disease. Br J Surg 81:1712–1721PubMedCrossRef Bradbury AW, Milne AA, Murie JA (1994) Surgical aspects of Behcet’s disease. Br J Surg 81:1712–1721PubMedCrossRef
12.
Zurück zum Zitat Ozeren M, Mavioglu I, Dogan OV, Yucel E (2000) Reoperation results of arterial involvement in Behcet’s disease. Eur J Vasc Endovasc Surg 20:512–516PubMedCrossRef Ozeren M, Mavioglu I, Dogan OV, Yucel E (2000) Reoperation results of arterial involvement in Behcet’s disease. Eur J Vasc Endovasc Surg 20:512–516PubMedCrossRef
13.
Zurück zum Zitat Iscan ZH, Vural KM, Bayazit M (2005) Compelling nature of arterial manifestations in Behcet disease. J Vasc Surg 41:53–58PubMedCrossRef Iscan ZH, Vural KM, Bayazit M (2005) Compelling nature of arterial manifestations in Behcet disease. J Vasc Surg 41:53–58PubMedCrossRef
14.
Zurück zum Zitat Hosaka A, Miyata T, Shigematsu H, Shigematsu K, Okamoto H, Ishii S et al (2005) Long-term outcome after surgical treatment of arterial lesions in Behcet disease. J Vasc Surg 42:116–121PubMedCrossRef Hosaka A, Miyata T, Shigematsu H, Shigematsu K, Okamoto H, Ishii S et al (2005) Long-term outcome after surgical treatment of arterial lesions in Behcet disease. J Vasc Surg 42:116–121PubMedCrossRef
15.
Zurück zum Zitat International Study Group for Behcet’s disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335:1078–1080 International Study Group for Behcet’s disease (1990) Criteria for diagnosis of Behcet’s disease. Lancet 335:1078–1080
16.
Zurück zum Zitat Ando M, Kosakai Y, Okita Y, Nakano K, Kitamura S (1999) Surgical treatment of Behcet’s disease involving aortic regurgitation. Ann Thorac Surg 68:2136–2140PubMedCrossRef Ando M, Kosakai Y, Okita Y, Nakano K, Kitamura S (1999) Surgical treatment of Behcet’s disease involving aortic regurgitation. Ann Thorac Surg 68:2136–2140PubMedCrossRef
17.
Zurück zum Zitat Tuzun H, Besirli K, Sayin A, Vural FS, Hamuryudan V, Hizli N et al (1997) Management of aneurysms in Behcet’s syndrome: an analysis of 24 patients. Surgery 121:150–156PubMedCrossRef Tuzun H, Besirli K, Sayin A, Vural FS, Hamuryudan V, Hizli N et al (1997) Management of aneurysms in Behcet’s syndrome: an analysis of 24 patients. Surgery 121:150–156PubMedCrossRef
18.
Zurück zum Zitat Le Thi Huong D, Wechsler B, Papo T, Piette JC, Bletry O, Vitoux JM et al (1995) Arterial lesions in Behcet’s disease. A study in 25 patients. J Rheumatol 22:2103–2113PubMed Le Thi Huong D, Wechsler B, Papo T, Piette JC, Bletry O, Vitoux JM et al (1995) Arterial lesions in Behcet’s disease. A study in 25 patients. J Rheumatol 22:2103–2113PubMed
19.
Zurück zum Zitat Kwon Koo B, Shim WH, Yoon YS, Kwon Lee B, Choi D, Jang Y et al (2003) Endovascular therapy combined with immunosuppressive treatment for pseudoaneurysms in patients with Behcet’s disease. J Endovascular Ther 10:75–80CrossRef Kwon Koo B, Shim WH, Yoon YS, Kwon Lee B, Choi D, Jang Y et al (2003) Endovascular therapy combined with immunosuppressive treatment for pseudoaneurysms in patients with Behcet’s disease. J Endovascular Ther 10:75–80CrossRef
20.
Zurück zum Zitat Jorizzo JL, White WL, Wise CM, Zanolli MD, Sherertz EF (1991) Low-dose weekly methotrexate for unusual neutrophilic vascular reactions: cutaneous polyarteritis nodosa and Behcet’s disease. J Am Acad Dermatol 24:973–978PubMedCrossRef Jorizzo JL, White WL, Wise CM, Zanolli MD, Sherertz EF (1991) Low-dose weekly methotrexate for unusual neutrophilic vascular reactions: cutaneous polyarteritis nodosa and Behcet’s disease. J Am Acad Dermatol 24:973–978PubMedCrossRef
21.
Zurück zum Zitat Davatchi F, Shahram F, Chams H, Akbarian N, Nadji A, Gharibdoost C et al (1998) Methotrexate for ocular lesions of Behcet’s disease. Cohort study on 262 patients. Arthritis Rheum 41(suppl):S356 Davatchi F, Shahram F, Chams H, Akbarian N, Nadji A, Gharibdoost C et al (1998) Methotrexate for ocular lesions of Behcet’s disease. Cohort study on 262 patients. Arthritis Rheum 41(suppl):S356
22.
Zurück zum Zitat Lakhanpal S, Tani K, Lie JT, Katoh K, Ishigatsubo Y, Ohokubo T (1985) Pathologic features of Behcet’s syndrome: a review of Japanese autopsy registry data. Hum Pathol 16:790–795PubMedCrossRef Lakhanpal S, Tani K, Lie JT, Katoh K, Ishigatsubo Y, Ohokubo T (1985) Pathologic features of Behcet’s syndrome: a review of Japanese autopsy registry data. Hum Pathol 16:790–795PubMedCrossRef
Metadaten
Titel
Surgical outcomes and risk factors for postoperative complications in patients with Behcet’s disease
verfasst von
Min-Chan Park
Bum-Kee Hong
Hyuck Moon Kwon
You-Sun Hong
Publikationsdatum
01.09.2007
Verlag
Springer-Verlag
Erschienen in
Clinical Rheumatology / Ausgabe 9/2007
Print ISSN: 0770-3198
Elektronische ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-006-0530-9

Weitere Artikel der Ausgabe 9/2007

Clinical Rheumatology 9/2007 Zur Ausgabe

Leitlinien kompakt für die Innere Medizin

Mit medbee Pocketcards sicher entscheiden.

Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag

Update Innere Medizin

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.